PATIENTS AND CAREGIVERS DISCUSS THE PHYSICIAN DISCUSSION

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby fogdweller » Thu Jan 13, 2011 5:17 pm

OK, so I am most definitely NOT a dr., but I am trying to interpret the "difficult catheterization" images. Where is the distal end of the catheter (i.e. where the dye is being injected) and what direction is the dye flowing? I am confused since the vein seems to be getting les and less constricted with fewer and fewer collaterals as it moves down toward the sinus (makes sens) but how does the dye get injected distal of all the collaterals? I am sure once it is explained I will feel silly.
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Postby AlmostClever » Thu Jan 13, 2011 7:56 pm

This is truly a unique internet treasure - public forum discussion between doctors of real cases!



Thanks Dr. S!
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Postby EJC » Fri Jan 14, 2011 5:04 am

What I find interesting is the vastly different opinions of the same scans.

That is quite an eyeopener for us non medical types.
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Postby girlgeek33 » Fri Jan 14, 2011 6:26 am

Very interesting, although much of it is like reading a foreign language to me.

And yes CeCe, once a rockstar, always a rockstar! ;)
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Postby Rokkit » Fri Jan 14, 2011 7:28 am

Cece wrote:So will Dr. Sclafani still be a Rockstar when he is 88?

If he is, will you still be his groupie? Kidding Cece. :D
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Postby Cece » Fri Jan 14, 2011 7:44 am

Once a rockstar, always a rockstar. :)

lol, Rokkit.

Dr. Cumming's idea of on-table ultrasound is reminiscent of the use of IVUS itself, they've already got one set of images with the xray as part of the procedure but a second set gives more information. It would be a third set if a doctor does all three.

phlebologist has seen one case of true agenesia! This addresses a question from last May, when there was a mismatch of people here at TIMS reporting that they had been diagnosed with a missing jugulars but none of the investigators had seen such cases and perhaps we were being misdiagnosed as having no jugular when it was merely a hyperplastic or difficult jugular to find.
(found the earlier conversation on this: http://www.thisisms.com/ftopicp-109202.html#109202 That was a hard find, it took ten minutes!) What I take from this is that true agenesia is possible but very very rare, so if you've been told you have a missing jugular, it is worth getting a second look.
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Postby scorpion » Fri Jan 14, 2011 11:00 am

EJC wrote:What I find interesting is the vastly different opinions of the same scans.

That is quite an eyeopener for us non medical types.
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a stupid idea

Postby frodo » Fri Jan 14, 2011 2:15 pm

Just a stupid idea about the pictures of the doctors discussion. We all have heard about cases in which IJVs were not developed or complete obstructed.

Could the answer be that none of the veins in the picture is the IJV?
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Postby civickiller » Sat Jan 15, 2011 12:14 am

my opinion on this case is that Upper Cervical Care is relatively cheap, why not try it, if its not it or doesnt help then scratch that from the board, no harm no foul.

This is process of elimination. you cant rule out anything till you've tried it

Ill admit, im alittle bias for upper cervical care because i am receiving UCC and I know how good it makes me feel. After my experience, I recommend everyone I know with MS to get UCC
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ccsvi

Postby blossom » Sat Jan 15, 2011 6:58 pm

civickiller, i agree 100 per cent. after all, with all the deformaties and even cases where there is pressure against these veins that some have that keeps the vein from staying open-wouldn't it make sence that if possible get problems out of the way that could be effecting this and then if necessary angioplasty. every patient seems to be having mixed improvements and failures and many post procedure problems.

myself, with the yrs. and damage acquired who knows. but, i did try angioplasty got a numb leg and no improvements and worry about possible complications. before i would try it again i want to clear up as much as possible with chiro. other problems with the hope it will help. what dr. flanagan is presenting makes a lot of sence. if i had been aware of his way of looking at things and treating i have no doubt with my history of trauma and symptoms that it would have been my first choice.

dr. sclafani's work with this and all of us is so so appreciated. he has spent a lot of time and effort trying to educate and help all of us. they are trying hard to perfect and get to the point of understanding and treating so we all will benefit lasting results. he definitely is a ccsvi hero.

so, my hope is that working together, these doctors from all the different specialties get the whole picture figured out soon.

i think history pretty much proves that these symptoms they named ms are not, and should not, be claimed and owned by any one particular type of medical professional. it hasn't worked in the past and i would hate to see history repeat itself.
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Re: ccsvi

Postby HappyPoet » Sat Jan 15, 2011 9:11 pm

blossom wrote:so, my hope is that working together, these doctors from all the different specialties get the whole picture figured out soon.

I emphatically agree!
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Postby Cece » Sat Jan 15, 2011 9:20 pm

Regarding Dr. Cumming's example:

Wow, the Mexico clinic has antiquated equipment. I don't know that we can recommend the Mexico clinic. :(

Is his example a true distal lesion? I've gotten used to seeing the waisting on an expanded balloon as the evidence of where the lesion is. IVUS images of the lesion, showing that it never changed size, would make a solid case too. But if it was not a true lesion, would ballooning have resulted in that nice-looking jugular after-picture?
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Postby civickiller » Sat Jan 15, 2011 10:04 pm

What I ask of the dr's trying to figure out MS is that, keep an open mind and don't dismiss dr's theories especially if u aren't trained in their specialties. Even a specialist could be wrong, Or else we wouldve had a cure for MS so please give every dr's theory a chance
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Postby HappyPoet » Sat Jan 15, 2011 10:24 pm

Distal from the brain or from the heart?
Am I wrong in thinking that each doctor's definition of "distal" (and "proximal") needs to be clarified?
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Postby drsclafani » Sun Jan 16, 2011 12:00 am

civickiller wrote:What I ask of the dr's trying to figure out MS is that, keep an open mind and don't dismiss dr's theories especially if u aren't trained in their specialties. Even a specialist could be wrong, Or else we wouldve had a cure for MS so please give every dr's theory a chance
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